Galectin-3 Could Help Predict Cardiovascular Events in Diabetics

This article originally appeared on Practical Cardiology’s sister site, EndocrinologyNetwork.com.

Results of a subgroup analysis of the REWIND trial suggest galectin-3 could help clinicians better predict a diabetic patient’s risk experiencing a cardiovascular event.

Results of the study, which included more than 900 patients with coronary artery disease (CAD), found galactic-3 plasma levels were associated with increased risk of cardiovascular events in patients with CAD and type 2 diabetes while monocyte chemoattractant protein-1 (MCP-1) and N-terminal fragment of brain natriuretic peptide (NT-proBNP) were predictive of events in patients with CAD but not type 2 diabetes.

“In CAD patients, cardiovascular events are predicted by galectin-3 plasma levels in patients with type 2 diabetes mellitus, and by MCP-1 and NT-proBNP in those without type 2 diabetes mellitus,” wrote study investigators.

Despite posing a serious threat to the health of diabetic populations as a whole, particularly those suffering from coronary atherosclerosis, clinicians and researchers have been unable to identify many reliable biomarkers for predicting cardiovascular events in type 2 diabetics. In an effort to close this knowledge gap, in estimators designed a study assessing the predictive value of multiple biomarkers for predicting the risk of events including acute ischemia, heart failure, or death. Of note, investigators chose a primary outcome as a combination of the secondary outcomes, which was the occurrence of the aforementioned adverse events.

For the study, investigators identified a cohort of 964 patients with coronary artery disease and information related to plasma levels of galectin-3, MCP-1, and NT-proBNP. The median duration of follow-up for this population was 5.39 (2.81-6.92). Of the 964 included in the study, 232 patients had a confirmed diagnosis of type 2 diabetes mellitus. Overall, 75% of the patients in the type 2 diabetes group and 76.6% of patients in the non-diabetic group were men (P=.609).

Investigators noted patients with diabetes had higher mean levels of MCP-1 (144 [133-195] vs 133 [105-173] pg/ml; P=.006) and galectin-3 (8.3 [6.5-10.5] vs 7.8 [5.9-9.8] ng/ml; P=.049) than their counterparts without type 2 diabetes mellitus.

Upon analysis, investigators found galectin-3 levels were associated with an increased risk of the study’s primary outcome in patients with type 2 diabetes (HR, 1.57; 95% CI, 1.07-2.30; P=.022), along with a history of cerebrovascular events. Investigators also found treatment with clopidogrel was associated with a lower risk of the primary outcome.

Results of the analysis also revealed NT-proBNP levels but not galactic-3 were associated with an increased risk of event in patients without diabetes (HR, 1.21; 95% CI, 1.04-1.42; P=.017), along with male sex and age. Additionally, galectin-3 was the only biomarker in the study investigators found was associated with development of acute ischemic events and heart failure or death in type 2 diabetics. However, MCP-1 (HR, 1.21; 95% CI, 1.04-1.42; P=.017) and NT-proBNP (HR, 1.23; 95% CI, 1.05-1.44; P=.012) were found to be associated with these outcomes in patients without diabetes.

“Galectin-3 was also the only biomarker that predicted the development of acute ischemic events and heart failure or death in T2DM patients, while in non-diabetics MCP-1 and NT-proBNP, respectively, predicted these events,” wrote study investigators.

This study, “Galectin-3 predicts cardiovascular events in patients with type-2 diabetes," was presented at ESC Congress 2020 by Ana Lorenzo-Almoros.